Syringe for blood transfusions



Jan. 2l, 1936:. RfMANN 2,028,161

SYRINGE FOR BLQOD TRANSFUSIONS i Filed- Feb. e, 1935 nlllmvlalmw l f 3" E u;

Patented Jan. 21, 1936 UNITEDv `STATES PATENT OFFICE 14 Claims.

extreme or last-resort cases, until comparatively 15 recent development and improvements in the means andmethods of performing transfusion operations ledto their more frequent adoption.

Advancing from direct transfusion by means of cannulae, or with intimain direct contact with intima, with various modications of the details of such methods, through direct mediate, or immediate transfusion accompanied by the use of an anticoagulant, such as phosphate or citrate of sodium, the practice has progressed to the point where direct transfusion with syringes is generally regarded as being superior to any other vmethod known heretofore. But there still remain various objections, perhaps the most serious of which isV that, without employing an anti- 30 coagulant, no syringe has been devised which provides for avoidance of the dangers and difficulties incident topclotting of the blood during the transfusion operation. By no means the worst, but nevertheless an extremely troublesome, effect of the tendency of blood that has not been defibrated to thicken and become very adhesive in a comparatively short time after it leaves the body, is the resultant interference with` the operation of the piston or plunger of Vthe syringe; e `and it has been found necessary to meet this condition, either by having the reciprocating part of the syringe wiped occasionally with gauze moist'ened with ether orthelike during the transfusion opplunger, but neither prevents formation of blood clots in the transmission channels leading to the.

terminal needles, or in the. needles themselves.

O'ne objection to the `use of an anticoagulant in connection with direct transfusion,r for the aforeeration, or to interrupt` the operation while the said ushing operation or otherwise, is that, while a comparatively small percentage of the anticoagulant is required in order to prevent clotting of blood, there must be a thorough and complete mixture of the two if localization of the anticalcinate action is to be avoided. Thus, when an anticoagulant is used in indirect transfusion, even when the solution is artiiicially mixed with the blood, as by shaking or other form of agitation, it is customary to strain the mixture through ne gauze, to insure the elimination of clots, before the transfusion is proceeded with. If, however, a normal saline solution, as of sodium chloride, is used vfor the flushing operation, no harmful' result is produced if such solution passes into the blood stream of the donor or the recipient, or both, in View of the very large percentage of normal saline constituent in the blood.

The primary object of the instant invention is to improve upon, and overcome the objections to the means and methods employed for blood transfusion, as known heretofore particularly in the following respects: 1

By providing a blood-transfusion syringe which shallbe adapted to transfer blood directly from the donor to the recipient, while inherently preventing clotting in the intake channel.

By providing such a syringe which shall inherently prevent clotting in the discharge channel.

By providing such a syringe which 'shall inherently prevent interference with movement of theV reciprocable member by coagulated or partially dried blood.

By providing such a` syringe in which either a simple diluent or an anticoagulant solution may serve as the medium for preventing Vinterference with movement of said reciprocable member.

By providing such a syringe in which either a simple diluent or an anticoagulant solution may be caused to circulate in the barrel or body of the instrument during the transfusion operation.

By providing such a syringe having a hollow piston Vor plunger in which either a simple diluent or an anticoagulant solution may be caused to circulate duringthe transfusion operation.

By providing such a syringe in which either a simple `diluent or an anticoagulant solution may be caused to circulate through the intake channel during the transfusion operation.

By providing such a syringe in which either a simple diluent or an anticoagulant solution may be caused to circulate through the discharge channel during the `transfusion operation.

By `providing such a syringein which either a simple diluent or an anticoagulant solution may be caused to pass with the blood into the vascular system of the recipient.

By providing such a syringe in which the piston or plunger is manually turnable in the barrel, to bring a groove or opening in such reciprocable part selectively into different position relative to the inlet and/or discharge parts; and including means'for defining such selective positions, and guiding the piston or plunger in its reciprocatory movement in the Yposition selected.

By providing such a syringe in which all parts with which the blood comes in contact may be made of glass.

By providing such a syringe which may be a self-contained single mechanical unit.

By providing a method of direct blood transfusion in which delivery of coagulated blood to the recipient may be prevented while the `blood is in transit from the donor to the recipient, by the use of either a simple diluent or an anticoagulant solution during the transfusion operation.

By providing such a method in which the blood delivered to the recipient may have the diluent or the anticoagulant solution interrnixed therewith during the transfusion operation, and while the blood is in transit.

By providing such a method in which circulation of either a simple diluent or an anticoagulant solution may take place in the transmission channels continuously during the transfusion operation.

By providing such a method in which cleansing of blood-contact portions of the transfusion apparatus with either a simple diluent or an anticoagulant solution may take place during the transfusion operation.

By providing such a method in which the simple diluent, or the anticoagulant, employed shall be a saline solution.

The means by which the foregoing and other desirable objects are accomplished bythe instant invention, and the manner of their accomplishment, readily will be understood from the following description on reference to the accompanying drawing, in which:

Fig. 1 is a central, ,longitudinalV section of a preferred form of my improved blood-transfusion syringe, with the piston or plunger shown in its most depressed working position, ready for the intake stroke.

Fig. 2 is a similar view, but with the piston or plunger shown in its uppermost working position, ready for the ejection stroke.

Fig. 3 is a side elevation of the same form of the instrument, on a reduced scale,

Fig. 4 is a sectional plan of the piston or plunger and the upper end ofY the barreljthe.

section being taken substantially on line IV-IV of Fig. 3.

Fig. 5 is a central sectional side elevation of an alternate form of the syringe, on the same scale as Fig. 3.

Fig. 6 is a sectional plan, the section being taken substantially on line VI-VI of Fig. 5.

Referring now to the drawing in detail, and iirst having reference to the preferred form of the instrument as illustrated in Figs. 1-4, the numeral I Il, indicates a hollow, cylindrical barrel, having a smooth and symmetrical inner surface, and having a closed lower end II, which is extended outwardly to form a concentric ilange I2, adapted toserve as a base for the syringe, and to cooperate in the retention of the instrument in place on a suitable support I3, as by means of a iixed bracket I and a pivoted clip I5. The barrel IIJ is open at its upper end, and is there provided with a flange comprising two substantially semi-circular portions I6 and I9, both of which are concentric with the barrel, the peripheral radius of the portion I6 being greater than that of portion Il, so that similar shoulders I8 and I9 are formed at opposite sides of the barrel. At diametrically-opposite sides of said barrel, approximately midway of its length, an inlet opening 20 and an outlet opening 2| are provided, each of said openings leading into a channelway extending through a cylindrical nipple, 22 and 23 respectively, preferably unitary with the barrel, and extending suii'iciently beyond the outer surface of the barrel to adapt said nipples for connection with lengths of rubber hose, tubing or the like (not shown).

A hollow, cylindrical piston or plunger 24, the upper portion of which is smooth and symmetrical, forms an air-tight, but reciprocable and turnable, closure for the open end of the barrel I, both ends of member 2li being closed. At its extreme upper end is a suitably-shaped handle portion 25, having an annular shoulder or iiange 25, adapted to coact with the flanges at the upper end of the barrel i0, to limit downward movement of the reciprocable member. An opening 2? in said handle portion communicates with a channelway extending through a cylindrical nipple 28, which projects a suliicient distance beyond the outer surface of said handle portion toadapt said nipple for the reception of a length of rubber hose or the like, 29. At the opposite side of said handle portion, a resilient strip of metal 30 is secured thereto, as by means of a screw 3i, said strip terminating yat its lower, free end in a thickened portion 32, having a curved or beveled inner face 33, and a shoulder 34 adapted to coact with the flanges at the upper end or" the barrel I0 to limit upward movement of the reciprocable member 24.

A substantially semi-circular groove 35 is formed in the outer surface of the piston or plunger, and, in the form of the instrument shown in Figs. 1 4, said groove extends entirely around said member. The location of said groove is such that it is Adisposed somewhat above the inlet and outlet openings, 2li and 2| respectively, when the reoiprocable member 2li is in its lowermost position, as sho-wn in Fig. l. An opening 36 extends from the interior of member 24 through the wall thereof, and communicates with groove 35. A longitudinal groove 37, disposed parallel with the axis of member 2d, and of substantially the same cross-sectional shape and area as groove 35, extends from said last-named groove to a point somewhat above the lower end of said member. At the diametrically-opposite side from groove 3l, a similar groove 38 extends from the extreme lower end of member 24 to a height such that it termintes above the level of the inlet and discharge openings, 20 and 2l respectively, when member 2d is in its lowermost position, as shown in Fig. l. v

In the alternate form ofthe instrument, Aas shown in Figs. 5 and 6, an opening 36A leads from the interior of a hollow reciprocable member 24A, through the wall thereof, and communicates directly with a vertical groove 39 which is the same as groove 3l of Figs. 1-4. At the diametrically opposite side of member 24A, is a longitudinal groove 38A, corresponding with groove 38 of Figs. 1 4, and above the upper end of groove.38A, at

the same level as opening 36A, a similar opening extends through the wall of said member, and communicates with a circumferential groove 4|, the respective ends of which communicate with longitudinal grooves 42 and 43, the lower'ends of which terrninateat substantially the same distance above the lower end of member 24A as is the terminus of longitudinal groove 39.

As indicated in the drawing, all parts of the syringe, except the metal strip 3|), preferably are made of glass; but the substitution of any other suitable material would not affect the operation of the instrument, or any of the desirable objects accomplished thereby. The barrel l0 preferably isprovided with suitable graduation marks 44, by which to determine the amount of blood drawn into said barrel, or ejected therefrom, when the piston or plunger has been moved to any position between its two extremes of movement.

In carrying out my improved method of blood transfusion, either of the two forms of improved transfusion syringes, as illustrated and described herein, may be employed; the manner of use of said -two forms being 'the same, and the groove 38 (or 38A) registers with the inlet opening 23, andthe longitudinal groove 31 (or 39) registers with the outlet opening 2|.

The tube or hose 29, which communicates with the interior of the hollow piston or plunger, is connected with a suitable receptacle (not shown) for the simple diluent or anticoagulant solution to be employed, and said receptacle is placed at such a height as will supply the desired amount of gravity pressure upon the solution as it is delivered to the syringe, such delivery being further controlled, if thought necessary or desirable, by introducing a valve, vor other now-regulating means, between the storage receptacle and the syringe. Some of the solution flows by gravity from the receptacle therefor through the tube 29 into, and lls, the hollow piston or plunger 24 (or 24A), and thence passesthrough the opening 36 into the circumferential groove 35 and the vertical groove 31 (Figs. 1 4), or through the Vopening 36A of `Figs. 5 and 6, and intothe vertical groove 39 of said figure; also through the opening 40 of Figs. 5 and 6, and into the partial circumferential groove 4|, and the vertical grooves 42 and 43, of said figures.

A suitable length of rubber hose,` or other preferably flexible tubing, having at one end a hypodermic needle, is Vattached to the inlet nipple 22, and a similar flexible member needle are applied to the outlet or ejection nipple 23. Such hose or tubes with attached hypodermic needles are old and well 'known in this art, and since no detail thereof forms any part of Vthe instant invention, they have been omitted from the drawing, and need not be further described herein.

When the piston or plunger is turned to position for the upward or intake stroke, the vertical groove 31 (or 39) is Ain communication with the outlet or ejectionchannel 2|,.and the solution may pass through said channel and into the hose or tube and needle connected therewith. Similarly, when the reciprocable member is turned to position for the downward or ejection stroke, the vertical groove 31 (or 39) is in communication with the intake channel 2| and the hose or tube and needle connected with said channel.

The donor and the recipient are prepared in the usual way for the transfusion operation, and the needles are applied to them in the same manner as for any other direct transfusion operation. Preferably, the syringe is primed with solution sufciently to insure the elimination of air from all transmission channels and is connected with the recipient and then with the donor. The piston or plunger is now raised manually, thereby drawing blood from the donor through the intake opening 20 and into the vertical groove 38 (or 38A) and thence into the barrel I0 of the instrument, below the lower end of the reciprocable member 24 (or 24A). During such upward movement of said member, groove 38 (or 38A) is maintained in alignment with inlet opening 20 by keeping the metal strip 20 in engagement with the shoulder I8 of the flanges at the top of the barrel of the instrument. If the amount of blood to be withdrawn at any upward movement of the piston or plunger is less than the capacity of the instrument, the extent of such movement may be regulated by means of the graduation marks'44 on the barrel, such as commonly are employed with dosage syringes. Or, if blood to the full capacity of the instrument is to be withdrawn, upward movement of the reciprocable member is continued until automatically terminated by engagement of the shoulder 34 of the metal strap 33 with the flange at the upper end of the barrel Ill.

Preparation for the downward or ejection stroke of the reciprocable member, is made by turning said membermanually anticlockwise until the metal strip 3|! seats against shoulder |9 of the flanges at the upper end of the barrel of the instrument, thereby aligning the vertical groove 38 (or 38A) with the ejection opening 2|, and such alignment is maintained by holding said strip against said shoulder thruout such downward stroke.

It will be seen that the blood in the groove 38 is carried above the inlet and outlet openings on the-upward stroke of the plunger and is swept half way around the barrel as the plunger is turned from the inlet opening to the outlet opening. Such blood is spread in a thin lm over the interior of that portion of the barrel surface and in part is transferred to the plunger surface, both on subsequent downward and turning movements so that a film of blood would be built up on both the plunger and barrel surfaces. As the plunger moves upward the flushing fluid in the circumferential groove wets a large portion of the barrel surface above these same inlet and outlet ports and is subsequently transferred to portions of the plunger which contact such wetted surface. Also the flushing fluid in the longitudinal groove 31, and in Figs. 5 and 6, in the longitudinal grooves 42 and 43 also, in turning movement wets con- Siderable portions of the barrel area. This subsequently wets portions of the plunger brought in contact therewith, whereby substantially the entire surfaceof both the barrel and plunger are sufficiently lubricated to prevent the accumulation of the film of coagulated or partially dried blood on such parts. y

Circulation of the solution, and its intermixture the intake channel and the ejection channel 2l, and the hose or tubes and needles connected therewith, is promoted continuously during the transfusion operation, by the gravity pressure of the solution and the reciprocatory movements of the piston or plunger.

I have found that in the practical use of my improved transfusion syringes, and the carrying out of my improved transfusion method, a normal saline (sodium chloride)V solution gives very satisfactory results, but I do not desire my invention to be interpreted as being limited to the use of any specific solution, especially since I have employed an anticoagulant, such as a sodium citrate solution, with complete success in transfusion operations in which my improved syringe and method were ,usedz I also desire it tobe specically understood that wherever the term saline solution" may be used in this description, or in the appended claims, such term is intended to be given the broad, general interpretation of a solution of a metallic salt, whether or not such solution be an anticoagulant.

While it has not been thought necessary to show in the drawing, or to describe, the receptacle from which the solution is delivered to the syringe, since the details of said receptacle form no part of the present invention, such receptacle preferably should be adapted to maintain the solution at a predetermined temperature thruout the transfusion operation, which temperature manifestly preferably should be in substantial accord with normal blood temperature.

Having now fully disclosed my invention, what I claim is: v

1. An instrument of the character described, comprising a hollow, cylindrical barrel, a piston reciprocable therein; said barrel having an inlet Iport and an outlet port, said piston having a circumferential groove so disposed as to communicate alternately with each of said ports in predetermined positions of said piston, and independent means maintaining communication between said groove and the exterior of said instrument.

2. An instrument of the character described, comprising a hollow, cylindrical barrel, and a pistonvreciprocable therein; said barrel having an inlet port and an outlet port, said piston having a longitudinal groove so disposed as to communicate alternately with each of said ports in predetermined positions of said piston, said groove terminating short of both ends of said plunger, and independent means maintaining communication between said groove and the exterior of said instrument.

3. An instrument of the character described, comprising a hollow, cylindrical barrel, a piston reciprocable therein; said barrel having'an inlet port and an outlet port, and said piston having a circumferential groove and a longitudinal groove, said grooves lying entirely between the ends of said piston, said grooves being so disposed that one thereof communicates alternately Vwith each of said ports in predetermined positions of said piston, and independent means maintaining communication between said grooves with the blood, in the vertical groove 31, and inv entiall groove and a plurality of longitudinal grooves, none of which communicates with either end of said plungers, said grooves being so disposed that one thereof communicates with one of said ports in a predetermined position of said piston, and independent means establishing com munication between said grooves and the exterior of said instrument.

5. An instrument of the character described, comprising a hollow, cylindrical barrel having a closed end and an open end, a piston reciprocable therein; said barrel having an inlet port and an outlet port, and said piston having a circumferential groove and a connecting longitudinal groove, neither of which are in communication with either end of said piston and independent means establishing communication between said groove and the exterior of said instrument; and said piston having a disconnected longitudinal groove extending to the inner end thereof, said longitudinal grooves being so disposed that one thereof is in communication with said inlet port, and another thereof is in communication with said outlet port, in a predetermined position of said piston.

6. An instrument of the character described, comprising a hollow, cylindrical barrel having a closedY end and an open end; a hollow plunger reciprocable in said barrel, said plunger having an opening for the admission of fluid thereinto, said barrel having an inlet port and an outlet port, and said plunger having a groove in its barrel-contact surface and an outlet opening cornmunicating with said groove, and means for dening positions of said plunger in which said groove may be brought selectively into commul nication with either of said ports.

'7. An instrument of the character described, comprising a hollow, cylindrical barrel having a closed end and an open end; a hollow plunger reciprocable in said barrel, said plunger having an opening for the admission of fluid thereinto, said barrel having an inlet port and an outlet port, and said plunger having connected circumferential and longitudinal grooves in its periphery and an outlet opening communicating with said grooves, means for dening positions of said plunger in which said longitudinal groove may be brought selectively into communication with either of said ports; and means for guiding said plunger in the selected position during reciprocative movement thereof,

8. An instrument of the character described, comprising a hollow, cylindrical barrel having a closed end and an open end; a hollow plunger reciprocable and turnable in said barrel, said plunger having an opening for the admission of iiuid thereinto, said barrel having an inlet port and an outlet port, and said plunger having a surface groove disposed longitudinally thereof; and an outlet opening communicating with said groove, and means for limiting turning movement of saidV plunger to define positions thereof in which said groove may be brought selectively into vengagement with either of said ports.

9. An instrument of the character described, comprising a' hollow, cylindrical barrel having a closed end andan open end, said barrel having an inlet port andanY outlet port, diametrically opposed; a hollow plunger reciprocable in said barrel, said plunger having an opening for the admission of fluid thereinto, and having in its periphery a circumferential groove and a pair of diametrically opposed longitudinal grooves, one only, of said latter grooves extending to the inner end of said plunger, and only the other thereof extending to said circumferential groove, said plunger having an outlet opening communicating with said circumferential groove; and means for positioning either of said longitudinal grooves in alignment with either of said ports and for guiding said plunger during reciprocatory movement thereof.

10. An instrument of the character described, comprising a hollow, cylindrical barrel having a closed end and an open end; said barrel having an inlet port and an outlet port, diametrically opposed; a hollow plunger reciprocable in said barrel, said plunger having an opening for the admission of fluid thereinto, and having in its periphery a pair of diametrically opposed, longitudinal grooves, one only of said grooves extending to the inner end of said plunger, and said plunger having an outlet opening communicating with the other of said grooves; and means for positioning either of said grooves in alignment with either of said ports and for guiding said plunger during` reciprocatory movement thereof.

11. An instrument of the character de'- scribed, comprising a hollow, cylindrical barrel having a closed end and an open end; said barrel having an inlet port and an outlet port; a hollow plunger reciprocable in said barrel, said plunger having an opening for the admission of fluid thereinto, and having in its periphery a circumferential groove and a longitudinal groove, said latter groove extending to the inner end of said plunger, but not communicating with said circumferential groove, and said plunger having an outlet opening communicating with said circumferential groove; and means for positioning said longitudinal groove in alignment with either of said ports and for guiding said plunger during reciprocatory movement thereof. 5 12. An instrument of the character described, including a hollow cylindrical barrel and a hollow piston reciprocable and turnable therein; said piston having, an opening for the admission of uid thereinto, a lateral outlet opening, a 10 circumferential groove in communication with said outlet opening, and a surface groove extending from said circumferential groove along said piston and terminating short of an end thereof.

13. In an instrument of the character de- 15 scribed, a hollow cylindrical barrel, and a hollow plunger reciprocable in said barrel; said barrel having an inlet port and an outlet port, and said plunger having an opening for admission of fluid thereinto and carrying means for establishing 20 communication between the interior thereof and selectively, either of said ports at respective predetermined positions of said plunger.

14. In an instrument of the character described, a hollow cylindrical barrel, and a hollow 25 plunger reciprocable in said barrel; said barrel having an inlet port and an outlet port, and said plunger having an opening for admission of fluid thereinto, and carryingA means for establishing communication between the interior thereof, and 30 selectively, either of said ports, and means for defming such selective positions of said plunger.

ROBERT MANN.' 

